Information Treasure Hunt: Supporting Evidence-Based Practice @ Your Institution Redux
Due to popular demand, instructor Connie Schardt returned to the Pacific Southwest Region to provide a second offering of the one-day workshop, Information Treasure Hunt: Supporting Evidence-Based Practice @ Your Institution. The workshop focused on study design, critical appraisal, systematic reviews, and qualitative studies, ending with putting it all into practice. Nearly forty attendees braved the wet weather to attend the event, hosted at the Parnassus Campus of the UCSF Library & Center for Knowledge Management on November 30, 2012.
Connie Schardt, MLS, AHIP, FMLA, is the Associate Director for Research and Education at the Medical Center Library at Duke University. In this position, her primary focus is to support the practice of Evidence-Based Medicine. Some of her activities include: course director for the MS3 EBM Course; liaison to the School of Medicine; and co-director of Teaching and Leading EBM: A Workshop for Teachers and Champions of Evidence-Based Medicine, an annual weeklong workshop for clinicians held at Duke University since 2003. In 2012, the Pacific Southwest Region was lucky enough to play host to Connie’s Information Treasure Hunt workshops, the first being held in Los Angeles in March, 2012, followed by the second one in San Francisco.
The workshop began with two simple principles of evidence-based medicine: the better the research, the more confident the decisions will be, and patient values and preferences must be incorporated into decision-making. With these two principles in mind, the workshop provided many small group exercises on how to critically appraise both quantitative and qualitative studies. The group activities not only served as icebreakers for attendees, but also allowed unique insights from the new and experienced learners of evidence-based practice.
In the last few months since the workshop, I have worked with the UCLA Clinical Practice Council (CPC) and have become more acquainted with evidence-based nursing practice. The CPC develops, reviews, and disseminates clinical nursing policies, guidelines, and practice alerts. To develop evidence-based policies, the nurses rely on the librarians to assist in obtaining quality articles and resources. Many of these articles are randomized controlled trials and systematic reviews, so I have found myself revisiting many of the concepts I learned during this class. The workshop introduced six validity criteria for randomized controlled trials, best remembered using the term “FRISBE”:
- Follow-up – Were all patients accounted for and attributed at its conclusion?
- Randomization – Was the allocation of patients to treatment randomized and concealed?
- Intent-to-treat analysis – Were all patient data analyzed in their original groups?
- Similar baseline – Were groups similar at the start of the trial?
- Blinding – Were patients, health professionals, and study administrators blind to treatment?
- Equal treatment – Were groups treated equally (aside from the experimental intervention)?
In addition, four validity criteria were given for systematic reviews and meta analysis:
- Frame it – Did the review address a specific and sensible question?
- Find it – Was the search for relevant studies detailed and exhaustive?
- Filter it – Were the primary studies of high methodological quality?
- Reproducibility – Were the assessments made by more than one reviewer and can be reproduced?
The Information Treasure Hunt workshop was an enlightening experience and I am very happy I was able to attend. If you would like to learn more about evidence-based practice, Connie Schardt and Jill Mayer have developed a wonderful online resource, Introduction to Evidence-Based Medicine, a tutorial that focuses on the six steps of evidence-based practice: assess the patient, ask the question, acquire the evidence, appraise the evidence, apply: talk to the patient, and self evaluation.